WPATH announces the 7th revision to the Standards of Care.

[Emily Ray]

I can only speak for what is happening here in the US. More and more private corporations small, medium and large, fully insured or self insured are getting rid of theexclusions against transsexual care. The document that they have been using to decide what to pay for and under what circumstances to do it has been the SoC. Many HR people don't have a clue about our medical needs and know even less about the process of transition. SoC 7 discusses voice and how help with it can lead to lessdysphoria.  I can see some really good policies covering speech pathology for us some day.


Huggs

Em

[Miniar]

No, they are not comparable, yet in well over 20 european countries vaginoplasty is required prior to gender recognition for transwomen while hysterectomy suffices in transmen.

Thereby the standards further the existing discrimination against women

The difference is in the standard of recognition, which is douchy.... :/

If hysto suffices for trans men, orchi should suffice for trans women.
End of story!

'course, where I live, 1 year hrt is the only requirement....

[Emily Ray]

Here were I live in Minnesota, Judges are willing to change birth certificates with just a noterized letter from a Dr who is treating us. I will be starting that proccess in two weeks and I am so excited

[Tippe]

You can get free BA in Denmark? That's cool. In Finland we don't :/ I would assume public health care also covers the cost of SRS?

Yes, the 3.3% of transwomen who are approved by the GIC can get BA and SRS on public health.

[Tippe]

The difference is in the standard of recognition, which is douchy.... :/

If hysto suffices for trans men, orchi should suffice for trans women.
End of story!

Better scrap the surgical requirements altogether.

Requiring orchi is impractical, because those who undergo vaginoplasty later in their transition will have worse results (more scars) if they do an orchi first. Some surgeons even refuse to operate on people who went through orchi.

Although a lot of human rights groups and powerful political institutions work to remove surgical requirements prior to legal recognition WPATH ought to consider the current state of a lot of countries.

That discussion is highly similar to the discussion of whether it is ethical to remove the diagnosis from DSM if it means - at some point - that transgender people face difficulty obtaining insurance coverage.

[missF]

Yes, the 3.3% of transwomen who are approved by the GIC can get BA and SRS on public health.

That's quite... low rate. Why's that? I don't know the numbers, but I'm sure finnish statistics are far higher than 3.3%

[missF]

The difference is in the standard of recognition, which is douchy.... :/

If hysto suffices for trans men, orchi should suffice for trans women.
End of story!

'course, where I live, 1 year hrt is the only requirement....

I would assume the differences are also related to the actual level of surgical technique - vaginoplasty is far easier to perform in transwoman than the its counterparts in transmen.

[Julie Marie]

How about this: you contact a doctor, tell him/her you want (fill in the blank), arrange for payment and schedule the surgery?

If you're an adult and of sound mind, why should someone else dictate what you can and can't do so long as you're not hurting anyone else?  Now, I'm not saying therapy and serious consideration should be thrown to the dogs, I feel both are something that could benefit practically anyone.  But considering there are no rules and regulations for FFS or BA (both far more visually feminizing socially than GRS), why all the rules and regulations about HRT and GRS? 

[Padma]

I think it's partly to cover the backs of the healthcare professionals against "buyer's remorse" - and also (at it's best) an expression of care, inasmuch as there are actual mental health disorders which have as their symptoms something resembling gender dysphoria. So they like to be sure you're not suffering from those before going ahead. But then it only took one visit to the psychiatrist to confirm that I wasn't showing "co-morbid" issues, so that should really get that out of the way.

I think it's also in a certain way wise to encourage people to take time (though it should still be their choice, ultimately), because most of the problems we're going to have when transitioning (however we're transitioning) are imposed upon us by the bigoted outside world. If no-one out there was bothered by the idea of transgender, it would be much more straightforward to be going through this. So perhaps there's a double-edged sword of care on the one hand, and prejudice on the other.

It's also more complicated in countries where it's possible to get treatment paid for by the state - so they have a duty of care (and of budget) to ensure they are treating people who really need the treatment.

[xxUltraModLadyxx]

anyway, i can't read it all, because it's too long i just like that the standards of care are evolving, and think it's a great thing.

[Tippe]

That's quite... low rate. Why's that? I don't know the numbers, but I'm sure finnish statistics are far higher than 3.3%

It's difficult to know why, but I believe it boils down to two reasons:
1. After the first widely published gender change in the fifties Danish doctors received letters from more than thousand transgender people around the world. In stead of making the operations available per pay Denmark chose to set extremely strict criteria to save the country from huge expenses.
That means Danish surgeons have limited experience with currently only one vaginoplasty each second year or so.
In turn this means a lot of complications and international research has shown that this affects quality of life post-operatively.

2. The Danish GIC does not do any research in transgender care and only seven months ago they published a book including a description of their evaluation of transgender people. They cited only two studies; one from 1984 and one from 1998! Obviously transgender care has evolved since then.

The fear of allowing people to have operations with severe complications should not be underestimated however, since we have documented that it is six times more easy (20%) for a transman to be accepted for gender correction than it is for a transwoman. Again this only requires hysterectomy and removal of the ovaries, both of whose are carried out 6.000 times a year in Denmark.

If you're an adult and of sound mind, why should someone else dictate what you can and can't do so long as you're not hurting anyone else?

Basically yes, because carefull consideration is far more likely in a setting where the care seeker decides when s/he is ready to proceed. In strict evaluation schemes the care seekers focus largely on presenting themselves in a way which allow them to get their permission. This limits their room for sincere considerations drastically.

[Emily Ray]

I know that things are changing here in the US because of advocacy outside of the SoC. The biggest change being lead by the HRC and its evolving standard of what counts for good coverage. I saw a report by them and for the companies who are covering HRT, mental health, and SRS is less than a cent. It is statisticaly insignificant. I don't know what influences healthcare change in Denmark or other Socialized medicical systems, but here in the US it is most effected by a need for qualified employees.

Huggs

Emily

[Gabby]

well they'd be wrong...being a woman is actually a social thing...being female is based on chromosomes.

Anyone who sets standards will find someone will set standards too, it's hard but it's a fact :/ 

Gender is completely personal as you've said elsewhere yourself:  "If you say something is female (or woman)  then it is."  If someone is genuine in their expression others see that, which is a great point you make, yeah?

@Padma, "who is a real woman", there's no such absolute mono blanket definition which is exactly why WPATH's strictness on requirements for HRT etc are being broken down over time (from reading reactions.)

I met my psychiatrist for the first time yesterday and he said to me at the end:  "I'm going to be person who gives you a kick you up the arse. There's 7 year olds walking around in dresses.  You should have transitioned when you were 18.   I'll see you in 3 months and I expect progress.  Write down all the things you want by then.  The real tragedy is not people like you, it's those who have gone out and are not accepted."  I have no idea if I will be accepted it's a scary thing, but to have a psychiatrist willing me on is probably the best feeling, I really hope the new WPATH is in this spirit, I really should read it rather then just posts over all the various forums haha

[Tammy Hope]

In some situations, if needed, health professionals may request verification that this
criterion has been fulfilled: They may communicate with individuals who have related to the patient
in an identity-congruent gender role, or request documentation of a legal name and/or gender
marker change, if applicable.

THIS is that of which I am speaking!



It's not like I've got ANY money, but if that should change - I've been full time for almost two years now and i don't want the clock to re-set.

[tekla]

By full time, does that include: changing name, changing gender ID markers, HRT, working as target gender?  That's what they are looking for.

[Gabby]

No, they are not comparable, yet in well over 20 european countries vaginoplasty is required prior to gender recognition for transwomen while hysterectomy suffices in transmen.

Thereby the standards further the existing discrimination against women

Is the UK one of those 20 countries?  I know, yes it is :/  I want that gender recognition before having a vaginoplasty as I may wait for a non-NHS procedure (still researching what to do in that regard).  Too deny gender recognition based on a sex organ?, and I'd challenge what they claim to be there because it may look like a duck but if it meows it sure aint what it seems (appologies for being slightly vulgar )

[Padma]

@Padma, "who is a real woman", there's no such absolute mono blanket definition which is exactly why WPATH's strictness on requirements for HRT etc are being broken down over time (from reading reactions.)

I was referring to the occasional tendency for people on this site to assert absolute definitions one way or another about this. There have been a lot of topics lately that have done this irresolvable discussion to death, and got quite messy in the process. I was just hoping we could avoid that cycle in this topic and stick to discussing what the new WPATH actually says.

[tekla]

I really should read it rather then just posts over all the various forums look like I'm out of it.

FIFY

[xxUltraModLadyxx]

a "real woman" is a shining blinding star of hyperfemininity and self assured of it at the same time. they are the highest intensity of woman

[Padma]

Oh well, that's me screwed then . Femininity is on my list of "optional" attributes for a woman .